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His former partner Berlinah Wallace, 48, is on trial at Bristol Crown Court accused of murder by leaving Mr Van Dongen with such serious injuries he asked for assistance in ending his life at a clinic in Belgium in January 2017.

Dr Rachel Oaten, who treated Mr Van Dongen in Southmead Hospital's emergency department said he was taken to a decontamination room where there was a mirror.

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He suffered a number of complications, including regular septic chest infections, septic infection of his left lower leg which resulted in it having to be amputated, blindness in his left eye and critical illness neuropathy (CIN).

Jonathon Pleat, a consultant burns surgeon at the hospital who was one of six involved in Mr Van Dongen's care, said CIN could affect people who spent extended periods of time in an intensive care unit (ICU) and could result in paralysis.

The court heard it left Mr Van Dongen only able to move his face and tongue.

Mark Van Dongen

Mr Pleat said Mr Van Dongen was "not able to communicate for four months or so" after the incident and spent six-and-a-half months in ICU before being transferred to the burns unit but had to go back to ICU after suffering from another infection.

"In summary... he had sustained profound and severe injuries not just to skin but to every system most seriously with his recurrent chest infections," he said.

"It was chest septicaemia that made him very unwell on a regular basis."

Mr Pleat said Mr Van Dongen spent 14 months in Southmead Hospital and was suffering from depression and PTSD.

He could become anxious, agitated and "almost paranoid", Mr Pleat said, adding: "I witnessed on a couple of occasions where he talked about the events of the time of injury and he would get understandably angry and agitated."

Mr Pleat said: "Mark was incredibly frustrated and the staff were professional at all times but, yes, on occasions he was very abusive."

Mark Van Dongen

Of his prognosis Mr Pleat said: "In my experience we have had no equivalent patient with such a horrible and extensive acid attack.

"It is difficult to say definitively what his prognosis would be.

"With regard to his skin I think it is likely he would have required more operations... (and) he would have required extensive care for the rest of his life."

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In a statement read to the court, consultant plastic surgeon Timothy Burge said Mr Van Dongen underwent numerous skin graft operations using donor skin from areas of his body not burnt by the acid, which left scars in those areas.

He said: "He had been permanently, irrevocably and drastically disfigured."

Mr Burge, whose statement was taken while Mr Van Dongen was still in hospital, said if he survived he would have to undergo months or years of physical rehabilitation.

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He added: "Mark will not be able to continue living the life he previously led."

Debra Speck, a senior carer from Holmleigh Care in Gloucester, where Mr Van Dongen was taken for rehabilitation after his discharge from hospital, said he looked "sad and disappointed" when he was shown his room.

She said he asked for a phone and called his father who arrived the next day and later arranged for an ambulance from Belgium to collect him and take him to the country.